Ablation for pain relief

So I am 6' 8" tall, or was until I started shrinking with age. Being pretty much of a klutz has not been kind to my back. Over the years I've developed some crazy random pain in my legs and hips and lower back.

In February of 2016, after too much tests and insurance headaches, Dr. Justin Spooner performed a Radio Frequency Ablation on my lower back, relieving my daily pains completely. It was dramatic, and it was wonderful.

(Side note: I went through the procedure's approval process twice. One of the questions you always get at pain clinics is, How much is your pain, on a scale of 1 to 10? With no defining terms, and having experienced some intense pain over my life, I rated my pain at 4 to 5 the first time around, and my insurance company (Aetna, FWIW) rejected paying for any relief. I tried to find out what they considered the numbers meant, but they simply replied that 5 wasn't high enough. So I started all over again, asserting my pain was 6 and 7, and the procedure was finally approved.)

In Spring of this year, 2018, I started to feel pain coming back to my legs and hips. As we traveled my pain returned, and we returned from our travels a bit early so I could start the process again.

This time my insurance and my Primary Care Physician sent me to Coastal Spine and Pain. They have a Beaches office that is close enough to bike to. Dr. Lee Irwin understood quickly where I was coming from, and got permission for a test epidural, just like I'd had twice before. but this time it didn't provide the short term (days) relief we expected. I went for a bike ride the day after the procedure, and had to cut it short, after 10 miles, due to intense pain in my right thigh. Sigh. But Dr. Irwin wasn't deterred, and did another epidural which was more successful.

The subsequent ablation has greatly enhanced my life. I still have some issues with my hips, and a bit of pain along my sciatica on my right thigh. But 90% of the pain that was always there is gone! I can sleep, I don't wake up in the middle of the night from pain, I can go for long walks or bike rides and only suffer from sore muscles, not random pains. It's silly that I've learned the difference between pain, but tired muscles are distinctly different from nerve pain. And I'm happy to suffer from tired muscles.

Coastal Pain also has a Physical Therapy component, and they were helpful reminding me of the exercises I was taught two years ago, along with a few more. And the exercise helps to keep the pain at bay.

One of the nice things I learned at Coastal Spine was a set of definitions of pain! There is a Makowitz Pain Scale! The definitions are

0. Pain Free
1. Very Minor Annoyance
2. Minor Annoyance
3. Annoying / Distracting
4. Can ignore if really involved in another activity
5. Can not be ignored for more than 30 minutes
6. Can not be ignored for any length of time; Can still work and participate in social activities.
7. Difficult to concentrate; Interferes with sleep; Still functions with effort.
8. Physical activity severely limited; Con read/converse with effort; Nausea and dizziness set in as factors of pain.
9. Unable to speak; Crying / moaning in pain; Uncontrollable near delirium.
10. Unconscious; Passed out due to pain.